CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Palos Community Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $713
Cash Discount Price: $666
vs. Medicare Baseline: 8.02x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Palos Community Hospital is $713. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $666. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 8.02x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$666

Average discount available for prompt cash payment at this facility.

Insurance Median

$713

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $666 (749%)

Insurance Median: $713 (802%)

Cash: $666 (749% of Medicare)

Ins. Median: $713 (802% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 802% of the Medicare baseline (a markup of 702%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$152 - $951	171%
Aetna	$204 - $951	229%
Carelon Behavioral Health [159]	$476	535%
Healthlink [125]	$476 - $951	535%
First Health Plan [6034]	$540 - $713	607%
Magellan Behavioral Hlth [136]	$571	642%
The Alliance [1703]	$611	687%
Compsych [112]	$713	802%
Beechstreet [176]	$761	856%
Cigna	$761 - $951	856%
Health'S Finest Network [126]	$808	909%
Galaxy Health Network [220]	$951	1070%
Global Excel [1712]	$951	1070%
Health Alliance [181]	$951	1070%
Multiplan/Phcs [142]	$951	1070%
UnitedHealthcare	$951	1070%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $666.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Palos Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.